Individual
MRS. JEAN MARIE BUNGART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
425 COLUMBIA AVE, MERCED, CA 95340-0914
(209) 723-3769
Mailing address
425 COLUMBIA AVE, MERCED, CA 95340-0914
(209) 723-3769
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
VN 183948
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5294237
—
CA
Enumeration date
01/25/2007
Last updated
07/08/2007
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